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Constitutional Intraepidermal ascent of Melanocytes. A potential pitfall in the diagnosis of Melanocytic Lesions


Kerl, K; Kempf, W; Kamarachev, J; Spallone, G; Braun, R; Wiesner, T; French, L E; Dummer, R (2012). Constitutional Intraepidermal ascent of Melanocytes. A potential pitfall in the diagnosis of Melanocytic Lesions. Archives of Dermatology, 148(2):235-238.

Abstract

BACKGROUND:
Transepidermal melanocytic migration (TEM) is an important diagnostic criterion for malignancy, especially in association with cytologic atypia. However, TEM may also be observed in benign melanocytic tumors, such as Spitz nevus, acral nevi, or nevi in infancy. We discuss the value of TEM for the diagnosis of melanocytic tumors in a young patient previously diagnosed as having 11 cutaneous melanomas.
OBSERVATION:
A 17-year-old patient with a history of 11 cutaneous melanomas diagnosed in the past 3 years by different expert dermatopathologists presented in our department. The previous histological diagnoses of melanoma were mainly based on the presence of important TEM. A reevaluation of all histological specimens in light of the clinical context and the lack of genomic aberrations as detected by array-comparative genomic hybridization led to a revision of the previous diagnoses. The striking TEM observed represents, in our opinion, a constitutional element of the melanocytic nevi in this patient and not a marker of malignancy.
CONCLUSION:
Awareness of this finding is important to avoid overdiagnosis of melanoma in cases of melanocytic nevi.

BACKGROUND:
Transepidermal melanocytic migration (TEM) is an important diagnostic criterion for malignancy, especially in association with cytologic atypia. However, TEM may also be observed in benign melanocytic tumors, such as Spitz nevus, acral nevi, or nevi in infancy. We discuss the value of TEM for the diagnosis of melanocytic tumors in a young patient previously diagnosed as having 11 cutaneous melanomas.
OBSERVATION:
A 17-year-old patient with a history of 11 cutaneous melanomas diagnosed in the past 3 years by different expert dermatopathologists presented in our department. The previous histological diagnoses of melanoma were mainly based on the presence of important TEM. A reevaluation of all histological specimens in light of the clinical context and the lack of genomic aberrations as detected by array-comparative genomic hybridization led to a revision of the previous diagnoses. The striking TEM observed represents, in our opinion, a constitutional element of the melanocytic nevi in this patient and not a marker of malignancy.
CONCLUSION:
Awareness of this finding is important to avoid overdiagnosis of melanoma in cases of melanocytic nevi.

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2 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Dermatology Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:27 February 2012
Deposited On:09 Jul 2012 09:06
Last Modified:05 Apr 2016 15:52
Publisher:American Medical Association
ISSN:0003-987X
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:10.1001/archdermatol.2011.2026
PubMed ID:22351826
Permanent URL: http://doi.org/10.5167/uzh-63181

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